D.J. Hindman is assistant professor, Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
S.R. Kochis is an allergy and immunology fellow, Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Acad Med. 2020 Dec;95(12):1908-1912. doi: 10.1097/ACM.0000000000003622.
To report on the implementation of a telephone medicine curriculum as part of the core clerkship in pediatrics for students at Johns Hopkins University School of Medicine and evaluate the curriculum's effect on student performance on a telephone medicine case as part of a required objective structured clinical exam (OSCE).
Using a prospective cohort design with a convenience sample of third-year medical students during the 2016-2017 and 2017-2018 academic years, the authors compared the OSCE scores of students assigned to the curriculum with both historical and concurrent control groups of students who had not received the curriculum. Additionally, the authors compared the costs of the recommended testing by students in each group using the 2018 Centers for Medicare and Medicaid Services Clinical Laboratory Fee Schedule.
Students assigned to the telephone medicine curriculum (students in the intervention group) had a significantly higher mean overall score on the simulated OSCE telephone medicine case compared with the students in the control groups who did not receive the curriculum (the mean score for students in the intervention group was 7.38 vs 6.92 for students in the control groups, P = .02). Additionally, the intervention group had statistically significantly lower costs for their recommended testing compared with the control groups (the median value for tests ordered by students in the intervention group was $27.91 vs $51.23 for students in the control groups, P = .03).
Implementing a dedicated telephone medicine curriculum for medical students improves their overall performance and delivery of high-value care via telephone medicine as part of an OSCE. Medical educators should pursue ongoing research into effective methods for teaching medical students and residents how to navigate digital encounters.
报告约翰霍普金斯大学医学院本科儿科核心实习课程中电话医学课程的实施情况,并评估该课程对学生在电话医学病例考试(客观结构化临床考试,OSCE)中的表现的影响。
采用前瞻性队列设计,对 2016-2017 学年和 2017-2018 学年的三年级医学生进行方便抽样,作者将接受该课程的学生的 OSCE 成绩与未接受该课程的历史对照组和同期对照组学生的成绩进行比较。此外,作者比较了每组学生根据 2018 年医疗保险和医疗补助服务中心临床实验室费用表建议进行的测试的成本。
与未接受课程的对照组学生相比,接受电话医学课程(干预组)的学生在模拟 OSCE 电话医学病例中的整体得分显著更高(干预组学生的平均得分 7.38 分,对照组学生的平均得分 6.92 分,P=0.02)。此外,干预组的推荐测试费用与对照组相比具有统计学意义上的显著降低(干预组学生订购的测试中位数为 27.91 美元,对照组学生为 51.23 美元,P=0.03)。
为医学生实施专门的电话医学课程可以提高他们的整体表现,并通过 OSCE 中的电话医学提供高价值的医疗服务。医学教育者应该继续研究如何有效地教授医学生和住院医生如何进行数字接触的方法。